Vol 30, No 3 (2013)

Aim. To improve the results of treatment of patients with nonparasitic hepatic cysts and to determine optimal treatment technique depending on concomitant pathology, terms of hospitalization, number of relapses and postoperative complications. Aim. To study the effect of isosorbide dinitrate (ISDN) on heart rate variability (HRV) in patients with stable functional class (FC) 1 and 2 stenocardia (St) associated with hypertensive disease (HD). Materials and methods. 194 patients with FC 1 and 2 St HD (mean age 54,5±5,2) were examined. Along with standard methods of investigation, high resolution rhythmocardiography (RCG) using diagnostic complex KAP-RK-01-“Micor” (T.F. Mironova, V.A. Mironov, Chelyabinsk, Registration Certificate №FS 02262005/2447.06) with temporary and spectral analysis of sinus heart rhythm (SHR) wave structure was applied. Results. Under the effect of ISDN, patients with Fc 1 and 2 St HD had significant rise in general heart rate variability (SDNN). Together with such shifts, there is growth of humoral-metabolic spectral characteristics (VLF%) – reliable in the background test ( p <0,05), tendency to increase in sympathetic (LF%) with fall in parasympathetic (HF%) – significant in the background test ( p <0,0001), Valsalva ( p <0,01) and Ashner ( p <0,0001) tests, with physical load – PWC 120 ( p <0,05). Arythmogenic effect of the investigated nitrovasodilator manifested by growth of ventricular and supraventricular extrasystoles, migration of auricle pacemaker, development of synoatrial node was observed. Conclusion. The method of rhythmocardiography helps to choose an antianginal therapy and predicts side effects of organic nitrates.

Aim. To study the peculiarities of spectral analysis of bioelectric cerebral activity in patients with generalized epileptic seizures in the interictal period. Materials and methods. 37 patients with generalized epileptic seizures in the interictal period were examined. Control group included 27 practically healthy persons. Spectrographic analysis of electroencephalography during the waking period was carried out. Mathematical processing was performed using Statistica 8.0 for Windows. Results. The dominating frequencies of electroencephalography were reduced in patients with epilepsy. Alpha-rhythm asymmetry in favour of the dominant left cerebral hemisphere was shown in men with generalized epileptic paroxysms in the interictal period. Conclusion. The dominating rhythm frequency is to be investigated so as to confirm the diagnosis of “epilepsy”. Alpha-rhythm asymmetry among men in favour of the dominant hemisphere in the interictal period as compared with healthy persons needs further studying.

Aim. To compare clinical manifestations and neuropsychological profile of cognitive disorders in patients with Alzheimer’s disease, vascular and mixed vasculodegenerative cognitive disorders at different stages of cognitive deficiency. Materials and methods. In 106 patients of The Center of Cognitive Disorders the status of four cognitive domains including memory, speech, visual-spatial and regulatory-dynamic functions was estimated during complex neuropsychological examination. Results. The applied method of comparing of neuropsychological parameters of patients at the identical stage of cognitive deficiency showed that differences in cognitive profiles between the indicated groups depend on the stage of the process. Conclusion. Differential diagnosis of three considered in the paper cognitive disorders types can be completely performed only at the stage of moderate dementia with evaluation of episodic, semantic memory and visual-spatial functions.

Aim. To study different surgical techniques and aids for primary surgical treatment of patients with traumatic hand and fingers defects so as to determine the most effective ones in restoration of anatomic structures of the hand and its grasp function. Materials and methods. Analysis of surgical treatment of 283 patients with open injuries of the hand and fingers and 417 operations was carried out. Primary surgical treatment was performed at early terms: 275 sufferers – during the first 6-12 hours, 18 persons with later admission had delayed surgery. Ultrasonic treatment of wounds and magneto-laser exposure was used to prepare the wounds for skin-and skin-bone grafting. Hyperbaric oxygenation was applied in the early postoperative period. Results. In connection with peculiarities of surgical treatment of patients with open hand and fingers injuries clinical observations were divided into three groups: primary restorative surgeries of the first finger, primary restorative surgeries in case of ulnar fingers defects and primary restorative surgeries in severe hand injuries. Analysis of direct results of treatment of 283 patients with severe hand and fingers injuries showed that 242 (87%) patients had primary tension wound healing with full graft and transplant taking. Outcomes of treatment were followed up in 176 sufferers (62%). Positive results were reached in 153 (87%) patients, unsatisfactory – in 23 (13%). Conclusion. The principal peculiar feature of primary surgical treatment in case of severe extensive injuries of the hand and fingers is its primary reconstructive character with rational use of a complex of plastic surgery facilities providing restoration of the basic function of the hand – its grasp function.

Aim. To study the patterns of detecting glycogen in ectocervix epithelium and neutral polysaccharides – in columnar epithelium in the zone of transformation among patients with human papilloma virus infection (HPV-infection). Materials and methods. The object of the study – 105 women aged 25 to 39 years who were diagnosed HPV-infection using PCR-method. Patients underwent standard gynecological examination and extended colposcopy with target (colposcopically oriented) biopsy of the uterine cervix. Bioptic material was subjected to histological investigation with generally accepted histological methods. Polysaccharide content of mucopolysaccharides was investigated on the basis of histochemical methods including analytical and enzymatic treatment (PAS-reaction with control diastase reactions; semiquantitative estimation of results by mean cytochemical coefficient). Histological specimens cells were calculated with 400-enlargement (x 400) of microscope on the test area of 0,042 mm 2, not less than in 5 vision fields for each specimen. Statistical analysis was performed using the program package Biostat. Statistical processing of the results was conducted with Kruscal-Wallis method. Results. Analysis of carbohydrate content (glycogen and neutral mucopolysaccharides) in the cells of multilayer flat and monolayer columnar glandular epithelium of uterine cervix in HPV-infected patients demonstrated decrease in flat epithelial cells glycogen content as CIN was progressing just till its full disappearance in patients with CIN III, as well as decrease in columnar (glandular) epithelial cells neutral mucopolysaccharide content as CGIN was progressing. The obtained data agree with a modern notion of dysplastic processes in flat and glandular uterine cervix epithelium and reflect dysplastic changes in multilayer flat and monolayer columnar epithelium which accompany human papilloma virus infection. Conclusion. Histological investigation of bioptic material obtained from patients with uterine cervix pathology associated with HPV-infection established the regularities of changes in multilayer flat ectocervix epithelium glycogen content as CIN was progressing and neutral mucopolysaccharide content as CGIN was progressing.

Aim. To give hygienic and clinical assessment of applying sylvinite devices in complex treatment of imflammatory periodontium tissue diseases. Materials and methods. The object of the study – the building equipped with two sylvinite devices. Hygienic methods were used to assess microclimate, ionizing radiation background, aeroionization and aerosol environment. The study included 49 patients (aged 20–25) diagnosed chronic generalized catarrhal gingivitis including 24 persons who underwent treatment by means of salt device. External examination was conducted; objective status of periodontium according to hygienic and periodontological indices was assessed. Results. Sylvinite devices contributed to formation of special internal environment with a complex of medical factors such as favorable aeroionization background, constant salt multicomponent aerosol concentration and stable microclimate. Sylvinite therapy included into the treatment of patients with chronic catarrhal gingivitis had a positive effect on periodontium tissues status and normalized local immunity indices of the oral cavity. Conclusion. The results of studies proved good perspectives for using silvinite devices in complex treatment of inflammatory periodontium diseases.

Aim. To assess the risk degree of occurring portal genesis hemorrhages in patients with hepatic cirrhosis. Materials and methods. The method of assessment of esophageal vein pressure combining direct endoscopic investigation and ultrasonic scanning was developed using endoscopic ultrasonography (EUS). Measurement of esophageal varicose vein (EVV) pressure was performed in 16 patients (9 men, 7 women, mean age – 56 years) suffering from hepatic cirrhosis. Results. The pressure values in esophageal veins ranged from 410 mm of water column to 730 mm of water column. All patients with hemorrhage in anamnesis had pressure > 600 mm of water column. The fulfilled endoscopic ligation appeared to be ineffective in case of vein pressure >700 mm of water column. Esophageal vein pressure determined with the suggested method objectively reflects hypertension in the portal tract. Conclusion. The above method is a low-invasive procedure allowing to assess all the most significant risk factors of hemorrhage including varics value, changes in vein-covering mucosa, vascular wall thickness, vein pressure.

Aim. To optimize assessment of the efficiency of preventive service in pediatric district. Materials and methods. Sociological survey of 200 parents and medical staff was carried out for reaching the aim. The real status of preventive service at the example of 366 children of the first year of life who were rendered medical care at children’s polyclinics of Municipal Budgetary Institution of Public Health “City Children’s Clinical Polyclinic №1” (CCCP) of Motovilikhinsky region of the city of Perm was studied. Functional model of district pediatrician’s activity regarding work with children of the first year of life was worked out. Results. Analysis of sociological survey showed that positive assessment of preventive activity conducted at children’s polyclinics was given only by 26% of parents, negative – by 14%, no estimation – 60%. Only a quarter of pediatricians and half of nurses gave satisfactory estimation of preventive activity in their district. At the same time, the share of preventive service in the actual volume of district pediatrician’s activity was 25-30%. Preventive activity quality criterion used for estimation of the efficiency of district pediatrician’s work permitted to reveal the reasons of the existing drawbacks and to change organization of preventive service at children’s polyclinic. Organizational and functional computer model for assessment of the activity of district pediatrician was created. Practical introduction of this system into the work of CCCP allowed to improve the quality of rendering preventive care to children and to widen its actual volume in the common activity of district pediatrician by 25% (25 to 50%). Conclusion. The developed model of district pediatricians’ activity regarding their work with children of the first year of life contributes to raising the quality of preventive service that positively influences health status of early age children.